GI Flashcards
1
Q
GI
A
GI
2
Q
What is the term for difficulty swallowing?
A
Dysphagia
3
Q
Bird-beak esophagus on barium swallow should make you think of what diagnosis?
A
Achalasia
4
Q
What is the most common location for an anal fissure?
A
Posterior midline
5
Q
Crohn’s is found where in the GI tract?
A
It can be from esophagus to anus.
6
Q
What does HBsAg (hep B surface antigen) indicate?
A
Active Hep B infection
7
Q
How do you treat achalasia?
A
Loosen up the muscle - botox, dilation or surgery
8
Q
A corkscrew appearance on barium study should make you think of what diagnosis?
A
Esophageal spasms
9
Q
Epigastric abdominal pain which radiates to the back should make you think of what diagnosis?
A
Pancreatitis
10
Q
In order to contract hepatitis D what must you already have?
A
Hepatitis B
11
Q
Left lower quadrant pain and tenderness should make you think of what diagnosis?
A
Diverticulitis
12
Q
What is the treatment for most Mallory-Weiss tears?
A
Watchful waiting, these will typically resolve within 48 hours.
13
Q
A thumbprint sign on an abdominal film should make you think of what diagnosis?
A
Intestinal ischemia
14
Q
What will the bowel sounds be early on in a small bowel obstruction? What will they be later on?
A
Early they are hyperactive. Late they are absent.
15
Q
A patient has had GERD for years. Over the past year, he has noticed an increase in difficulty swallowing his food. This should make you think of what diagnosis?
A
Esophageal strictures
16
Q
What are two treatments you should consider for esophageal strictures?
A
Dilation of the esophagus and long term PPIs.
17
Q
What are two common predisposing factors for esophageal varices?
A
Portal HTN and cirrhosis often caused by alcoholism.
18
Q
What is a common symptom that goes along with chest pain for GERD patients?
A
Dry cough
19
Q
What medication is most commonly used for long term treatment of GERD?
A
Proton pump inhibitors - omeprazole, lansoprazole pantoprazole
20
Q
What is the imaging modality of choice for pancreatitis?
A
CT
21
Q
What is the best test to check for H. pylori?
A
Urea breath test
22
Q
Is peptic ulcer disease more common in the duodenum or the stomach?
A
Duodenum
23
Q
What is the most common location for a pancreatic tumor?
A
75% occur in the head of the pancreas.
24
Q
With a gastric ulcer are the patient’s symptoms exacerbated or relieved with food?
A
Exacerbated
25
Fasting gastrin will be above what level with gastrinoma?
>150 pg/ml
26
Projectile vomiting should make you think of what diagnosis?
Pyloric stenosis
27
Most gallstones are made of what substance?
Cholesterol
28
What is the name of the sign when a patient shows inhibited inspiration with pressure over the RUQ? What diagnosis does it suggest?
Murphy's sign, Cholecystitis
29
What is the most specific test for acute cholecystitis?
HIDA
30
What is the gold standard for diagnosis and treatment of bile duct stones?
ERCP
31
What is Charcot's triad?
RUQ pain, fever jaundice
32
What is Reynold's pentad and why does it matter?
Charcot's triad + hypotension + altered mental status. It indicates high risk of sepsis.
33
What disease is defined as an immunologic response to gluten?
Celiac
34
What is the main risk factor for esophagitis?
Immunocompromised patient
35
An endoscopy for presumed esophagitis shows multiple shallow ulcers. What is the most likely diagnosis?
Herpes simplex virus
36
List two common offending agents for pill induced esophagitis?
NSAIDS, KCl iron, antibiotics
37
A 30 year old African American woman presents with dysphagia. You notice she also has thickened skin. A barium swallow demonstrates the absence of peristalsis. What is the most likely diagnosis?
Scleroderma
38
A patient complains of regurgitating undigested food several hours after a meal. What is the most likely diagnosis?
Zenker's diverticulum
39
What is the most common cause of peptic ulcer disease?
H. pylori
40
What is the most specific diagnostic test for peptic ulcer disease?
Endoscopy
41
What is the only curative therapy for gastric adenocarcinoma?
Surgical resection
42
A patient presents complaining of right upper quadrant pain 20 minutes after meals. What is the most likely diagnosis?
Cholecystitis
43
What does ERCP stand for?
Endoscopic retrograde cholangiopancreatography
44
What is the most common cause of acute bacterial cholangitis?
Choledocholithiasis
45
Onion ring fibrosis from a bile duct biopsy should make you think of what diagnosis?
Primary sclerosing cholangitis
46
What two viral hepatitis infections are self limiting?
Hepatitis A and hepatitis E
47
Pica is often related to what type of anemia?
Iron deficiency anemia
48
What does an Anti-HBc (hep B core antibody) indicate?
Previous or ongoing hepatitis B infection
49
What does Anti-HBs (hep B surface antibody) indicate?
Recovery from infection or immunization to hepatitis B
50
What it is the recommended treatment for hepatitis C infection?
Pegylated interferon alpha-2
51
What medication used in hepatitis B infection helps prevent the need for liver transplant?
Lamivudine
52
There are vaccines for which two versions of hepatitis?
Hepatitis A and hepatitis B
53
Will a patient with achalasia have dysphagia to liquids, solids or both?
Both
54
If you have heartburn that does not improve with medication what is the most likely diagnosis?
Gastrinoma
55
What are the two main complications of cirrhosis?
Portal HTN & liver insufficiency
56
What is a good beta blocker to reduce portal HTN?
Propranolol
57
What tumor marker may be used for liver cancer?
alpha-Fetoprotein
58
What are the two most common causes of pancreatitis?
Cholelithiasis and ETOH
59
Describe Cullen's sign.
Umbilical ecchymosis often related to pancreatitis.
60
What are the 5 points of Ranson's criteria on admission?
older than 55, WBC>16 glucose>200 LDH>350 AST>250
61
What is the first step in treating GERD?
Lifestyle modification
62
Steatorrhea should make you think of what diagnosis?
Pancreatitis
63
Describe Courvoisier's sign.
Nontender, palpable gallbladder which may indicate pancreatic neoplasm.
64
What tumor marker can be used to follow pancreatic cancer?
CA-19-9
65
A patient complains of periumbilical pain which has now moved over McBurney's point. What is the most likely diagnosis?
Appendicitis
66
Describe how to perform the psoas sign.
The patient is supine and attempts to raise the right leg against resistance.
67
What is the term for painful swallowing?
Odynophagia
68
Describe how to perform the obturator sign.
The patient is supine and attempts to flex and internally rotate right hip.
69
What is the best imaging study for acute appendicitis?
CT
70
What two blood test can be used to diagnose celiac?
IgA endomysial antibody and IgA tTG antibody
71
How much fiber should you normally get in a day?
About 30 grams
72
What treatment should be started for asymptomatic diverticulosis?
None
73
Is surgery curative for Crohn's or ulcerative colitis?
Ulcerative colitis
74
What causes Mallory-Weiss tears?
Forced vomiting or retching (often involving alcohol)
75
A colonoscopy that shows cobblestone or skip lesions should make you think of what diagnosis?
Crohn's disease
76
What class of medication is first line to treat inflammatory bowel disease in the maintenance phase?
5-ASA products - sulfasalazine, mesalamine
77
Currant jelly stool should make you think of what diagnosis?
Intussusception
78
Severe abdominal pain 30 minutes after a meal should make you think of what diagnosis?
Intestinal ischemia
79
What is the most common cause of lower GI bleed?
Diverticulosis
80
What is the most common location of colorectal cancer?
Cecum about 38%
81
Colorectal cancer patients are almost all older than what age?
90% of patients are older than 50.
82
An epigastric olive-shaped mass should make you think of what diagnosis?
Pyloric stenosis
83
An elevated serum amylase and lipase should make you think of what diagnosis?
Pancreatitis
84
Under routine circumstances when should patients begin getting screening colonoscopies?
Age 50
85
What is the #1 cause of small bowel obstruction?
Postoperative adhesions
86
Air fluid levels on abdominal x-ray should make you think of what diagnosis?
Bowel obstruction
87
Which is more likely to pass into the scrotum a direct or indirect hernia?
Indirect
88
A string sign on barium swallow should make you think of what diagnosis?
Pyloric stenosis
89
What is the first line of treatment for an anal fissure?
Fluid and fiber
90
What are two things that an anal fissure off midline might suggest?
Crohn’s, syphilis, HIV, neoplasm
91
What medical treatment is given for a gastrinoma?
Proton pump inhibitors
92
What is the term for an abscess in the sacrococcygeal cleft?
Pilonidal disease
93
How do you treat an H. pylori infection?
PPI + 2 antibiotics, commonly omeprazole + clarithromycin and amoxicillin or PPI +metronidazole + tetracycline
94
Painless bright red blood per rectum should make you think of what diagnosis?
Hemorrhoids
95
A patient on sulfasalazine for an inflammatory bowel disease should be supplemented with what vitamin?
Folate
96
What is the most common anorectal problem affecting patients over 50?
Hemorrhoids
97
A gastrinoma is also known as what syndrome?
Zollinger-Ellison syndrome
98
Salivary amylase breaks down what macronutrient?
Carbohydrates
99
What is the medical term for feeling like there is a lump in your throat?
Globus
100
What is the most common vessel blocked with intestinal ischemia?
Superior mesenteric artery
101
Describe Grey-Turner's sign.
Flank ecchymosis often related to pancreatitis
102
What are the first three steps of managing pancreatitis?
NPO, pain control fluids
103
A patient presents with unproductive retching, acute localized epigastric distention and inability to pass a nasogastric tube. What is the most likely diagnosis?
Gastric volvulus
104
What is the most common cause of a folate deficiency?
Alcoholism
105
Should diverticulitis always be admitted?
No, mild cases can be treated as outpatients with rest and clear fluids.
106
Which NSAID has the highest rate of peptic ulceration?
Naproxen
107
What is the diagnostic test of choice for Zenker's diverticulum?
Barium swallow will show the diverticulum.
108
What is the leading cause of iron deficiency anemia?
Chronic GI bleed
109
At what age and how often should fecal occult blood tests be performed as a screening tool?
Beginning at age 50, and they should be done every year.
110
How often should patients with pernicious anemia have a screening endoscopy performed?
Every 5 years looking for signs of gastric carcinoma.
111
Are one half of all adult hernias direct or indirect inguinal hernias?
Indirect inguinal hernias makeup 50% of all adult hernias.
112
How is celiac disease most commonly diagnosed?
Endoscopic biopsy
113
Define pellagra?
Niacin (B3) deficiency
114
An endoscopy for presumed esophagitis shows several solitary deep ulcers. What is the most likely diagnosis?
Cytomegalovirus
115
Which are more painful, hemorrhoids above or below the dentate line?
Below, internal hemorrhoids are not painful.
116
An abdominal exam with pain out of proportion to the exam should make you think of what diagnosis?
Intestinal ischemia
117
Does adenocarcinoma arise from the proximal or distal esophagus?
Distal
